Source: CMAJ  |  Posted 10 years ago

Among most patients with major depression, an integral part of their condition is probably some social component of their lives.

British researcher Dr. Thomas J. Scheff suggests that the social component is "closely tied to the immediate situation" of the depressed patient.

He notes that there are many theories of the causes of depression. "They all assume that some cases are primarily endogenous " that is, that they are largely independent of situational influences."

His own experiences with depressed patients indicate otherwise, he says.

"During five months in 1965, I observed nearly all intake interviews of male patients in a mental hospital near London. Most of the patients were older than age 60 years, and all but one were diagnosed as depressed.

"There was usually a temporary lifting of depression in those interviews in which the psychiatrists asked the patients about their activities during World War II."

Dr. Scheff says that at the time he didn't understand the significance of the temporary lifting of depression.

"I now offer an interpretation, in the light of current studies of shame and the social bond: recounting memories of belonging to a community temporarily resolved shame and depression."

Dr. Scheff theorizes that these episodes mean there should be "a modification of existing theories of depression, that shame and lack of community, in addition to biology and individual psychology, could be a component in major depression."